MINNESOTA DEPARTMENT OF HEALTH
Weekly Influenza & Respiratory Illness Activity Report
A summary of influenza surveillance indicators prepared by the Division of Infectious Disease Epidemiology Prevention & Control
Summary of the 2013-14 Season
All data are preliminary and may change as more reports are received
Summary of the 2013-14 Season
•
Since the start of the influenza season, 1,539 people were hospitalized with laboratory-confirmed influenza.
•
Since the start of the influenza season, 2 pediatric influenza-related deaths were confirmed.
•
Since the start of the influenza season, 27 outbreaks of influenza in long-term care were reported.
•
Since the start of the influenza season, 93 outbreaks of ILI in schools were reported.
Minnesota Influenza Surveillance Website: www.health.state.mn.us/divs/idepc/diseases/flu/stats/
Weekly U.S. Influenza Surveillance Report: www.cdc.gov/flu/weekly/
World Health Organization (WHO) Surveillance: www.who.int/influenza/surveillance_monitoring/updates/en/
Google Flu Trends: www.google.org/flutrends/us/
Neighboring states’ influenza information:
Iowa
Wisconsin
North Dakota
South Dakota
ww.idph.state.ia.us/IdphArchive/Archive.aspx?channel=FluReports
www.dhs.wisconsin.gov/communicable/influenza/surveillance.htm
www.ndflu.com/default.aspx
http://doh.sd.gov/diseases/infectious/flu/
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
1
Hospitalized Influenza Surveillance
Hospitalized influenza cases are based on disease reports of laboratory-positive influenza (via DFA, IFA, viral culture, EIA, rapid test, paired
serological tests or RT-PCR) and specimens from hospitalized patients with acute respiratory illness submitted to MDH-PHL by hospitals and
laboratories. Due to the need to confirm reports and reporting delays, consider current week data preliminary.
Hospitalized Influenza Cases by
Season, Minnesota (FluSurv-NET*)
B
A (not subtyped)
A H3
A H1 (unspecified)
A (H1N1)pdm09
A (H1N2v)
A (H3N2v)
A&B
Unknown
240
220
200
180
160
140
120
100
80
40 42 44 46 48 50 52 2
4
6
MMWR Week
8 10 12 14 16 18
Hospitalizations this
week
Hospitalizations last
week
Total (to date)
--
--
1,539
*Influenza Surveillance Network
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
2008-09
2009-10
2010-11
2011-12
2012-13
2013-14
600
550
500
450
400
350
300
250
200
150
100
0
40
0
650
50
60
20
Number of Hospitalizations
Number of Hospitalizations
Hospitalized Influenza Cases by Type
Minnesota (FluSurv-NET*)
40 42 44 46 48 50 52 2
Season
2008-2009
2009-2010
2010-2011
2011-2012
2012-2013
2013-2014
4
6
MMWR Week
Hospitalizations current
week (historic)
-------
8 10 12 14 16 18
Total
293
2,060
965
556
3,068
1,539
2
Number of Hospitalizations
# of hospitalizations
Incidence (cases) per 100,000 Persons
48.7
31.2
31.1 29.1
22.8 22.0
20.1
15.3
70.0
65.0
60.0
55.0
50.0
45.0
40.0
35.0
30.0
25.0
20.0
15.0
10.0
5.0
0.0
Region
Region
Central
Metro
Northeast
Northwest
South Central
Southeast
Southwest
West Central
Hospitalizations this
week
Total (to date)
---------
227 (15%)
829 (54%)
159 (10%)
24 (2%)
91 (6%)
113 (7%)
49 (3%)
47 (3%)
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
600
550
500
450
400
350
300
250
200
150
100
50
0
Number of Influenza Hospitalizations and
Incidence by Age, Minnesota
Sept 29, 2013 – May 3, 2014
# of hospitalizations
Incidence (cases) per 100,000 Persons
68.5
42.8
25-49
80.0
70.0
40.0
30.0
20.0
8.9
5-24
90.0
50.0
17.8
0-4
100.0
60.0
51.5
50-64
Age Group (years)
65+
Hospitalizations per 100,000 Persons
1100
1000
900
800
700
600
500
400
300
200
100
0
Hospitalizations per 100,000 Persons
Number of Influenza Hospitalizations and
Incidence by Region, Minnesota
Sept 29, 2013 - May 3, 2014
Number of Hospitalizations
Hospitalized Influenza Surveillance - continued
10.0
0.0
Median age (years) at time of admission
54.8
3
Respiratory Disease Outbreak Surveillance
School Outbreaks
K-12 schools report an outbreak of influenza-like illness (ILI) when the number of students absent with ILI reaches 5% of total enrollment or
three or more students with ILI are absent from the same elementary classroom
Number of influenza-like illness outbreaks
Influenza-like Illness (ILI) in Schools by Season
125
2010-11
2011-12
2012-13
2013-14
100
75
50
25
0
40 41 42 43 44 45 46 47 48 49 50 51 52
1
2
3
4
5
MMWR Week
6
7
8
9
10 11 12 13 14 15 16 17 18 19 20
Total
93
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
4
Respiratory Disease Outbreak Surveillance
Long-Term Care (LTC) Outbreaks
LTC facilities report to MDH when they suspect an outbreak of influenza in their facility. Laboratory confirmed outbreaks are reported here
Number of influenza-like illness outbreaks
Influenza-like Illness (ILI) in LTC by Season
70
65
2010-11
60
55
2011-12
2012-13
2013-14
50
45
40
35
30
25
20
15
10
5
0
MMWR Week
Total (to date)
27
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
5
Sentinel Provider Surveillance (Outpatients)
MDH collaborates with healthcare providers who report the total number of patients seen and the total number of those patients presenting to
outpatient clinics with influenza-like illness.
Percentage of Persons Presenting to Outpatient Clinics with Influenza-Like Illness (ILI)
Percent with Influenza-like Illness
8
2010-11
7
2011-12
2012-13
2013-14
6
5
4
3
2
1
0
40 41 42 43 44 45 46 47 48 49 50 51 52 1
2
3
4
5
MMWR Week
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
6
7
8
9 10 11 12 13 14 15 16 17 18 19 20
6
Laboratory Surveillance
The MN Lab System (MLS) Laboratory Influenza Surveillance Program is made up of more than 310 clinic- and hospital-based laboratories, voluntarily submitting testing
data weekly. These laboratories perform rapid testing for influenza and Respiratory Syncytial Virus (RSV). Significantly fewer labs perform PCR testing for influenza and
three also perform PCR testing for other respiratory viruses. MDH-PHL provides further characterization of submitted influenza isolates to determine the hemagglutinin
serotype to indicate vaccine coverage. Tracking the laboratory results assists healthcare providers with patient diagnosis of influenza-like illness and provides an
indicator of the progression of the influenza season as well as prevalence of disease in the community.
Specimens Positive for Influenza by RT-PCR, by Week
400
300
250
200
150
B
40
A (not subtyped)
A H3
35
A (H1N1) pdm09
2011-12 % + by PCR
30
2010-11 % + by PCR
25
2012-13 % + by PCR
2013-14 % + by PCR
20
15
100
10
50
0
Percent of RT-PCR Positive
Number of RT-PCR Positives
350
45
5
40 41 42 43 44 45 46 47 48 49 50 51 52 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20
0
MMWR Week
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
7
Laboratory Surveillance – Rapid Test
MLS Laboratories – Influenza Testing
MLS Laboratories – RSV Testing
Specimens Positive by Influenza Rapid Test, by Week
B+ (2013-14 Season)
A+ (2013-14 Season)
2010-11 % +
2011-12 % +
2013-14 % +
40
35
30
25
20
15
10
5
40 42 44 46 48 50 52 2
4
6
MMWR Week
8 10 12 14 16 18 20
Number of Positive RSV Tests
2012-13 % +
350
0
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
Number +
2010-11 % +
2012-13 % +
2009-10 % +
2011-12 % +
2013-14 % +
70
65
300
60
55
250
50
45
200
40
35
150
30
25
100
20
15
50
0
75
10
40 42 44 46 48 50 52 2 4 6 8 10 12 14 16 18 20
MMWR Week
Percentage of Rapid RSV Tests Positive
1000
950
900
850
800
750
700
650
600
550
500
450
400
350
300
250
200
150
100
50
0
2009-10 % +
Percentage of Rapid Influenza Tests Positive
Number of Positive Influenza Specimens
A/B+ (2013-14 Season)
Specimens Positive by RSV Rapid Test, by Week
5
0
8
Laboratory Surveillance – PCR
MN Influenza Incidence Project (IISP) - Outpatients
Pathogens Detected, Minnesota IISP – 2013-14
Influenza B
Influenza A Unspecified
Rhinovirus
Coronavirus OC43
Parainfluenza-1
Parainfluenza-4
Number Positive by RT-PCR
25
20
Influenza A H3
RSV
Adenovirus
Coronavirus 229E
Parainfluenza-2
Influenza A (H1N1) pdm09
Human Metapneumovirus
Coronavirus NL63
Coronavirus HKU1
Parainfluenza-3
15
10
5
0
32
34
36
38
40
42
44
46
48
*Indicates current week-data may be delayed by 2 or more weeks
50
52
2
MMWR Week
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
4
6
8
10
12
14
16
18
20
9
Laboratory Surveillance – Viral Culture
MDH-PHL
Minnesota Virology Laboratories (MLS)
Viral Culture Positive Influenza Subtypes,
by Week
B / Yamagata lineage
A (subtype undetermined)
A (H1N1) pdm09
20
15
10
5
0
Influenza B
Number of Positive Viral Culture Specimens
Number of Positive Influenza Specimens
25
B
B / Victoria lineage
A H3
Viral Cultures Positive for Circulating
Respiratory Viral Pathogens, by Week
Influenza A
RSV
60
Human Metapneumovirus
Rhinovirus
55
Adenovirus
Enterovirus
50
Parainfluenza-1
45
Parainfluenza-2
Parainfluenza-3
40
Parainfluenza-4
35
30
25
20
15
10
5
40 42 44 46 48 50 52 2
4
6
8 10 12 14 16 18 20
MMWR Week
*Indicates current week
Minnesota Department of Health Weekly Influenza & Respiratory Activity | Summary 2013-14
0
40 42 44 46 48 50 52 2
4
6
MMWR Week
8 10 12 14 16 18 20
10